Search Results (124)

Background: Out-of-hospital cardiac arrest (OHCA) survivors and their relatives may face challenges following hospital discharge, relating to mood, cognition, and returning to normal day-to-day activities. Identified research gaps include a lack of knowledge around what type of intervention is needed to best navigate recovery. In this study, we investigate the feasibility and patient acceptability of a new virtual psychoeducational group intervention for OHCA survivors and their relatives and compare it to a control group receiving a digital information booklet. Methods: V-CARE is a comparative, single-blind randomized pilot trial including participants at selected sites of the STEPCARE trial, in the United Kingdom and Sweden. Inclusion criteria are a modified Rankin Scale (mRS) ≤ 3 at 30-day follow-up; no diagnosis of dementia; and not experiencing an acute psychiatric episode. One caregiver per patient is invited to participate optionally. The intervention group in V-CARE receives four semi-structured, one-hour-long, psychoeducational sessions delivered remotely via video call by a trained clinician once a week, 2–3 months after hospital discharge. The sessions cover understanding cardiac arrest; coping with fatigue and memory problems; managing low mood and anxiety; and returning to daily life. The control group receives an information booklet focused on fatigue, memory/cognitive problems, mental health, and practical coping strategies. Results: Primary: feasibility (number of patients consented) and acceptability (retention rate); secondary: satisfaction with care (Client Satisfaction Questionnaire 8 item), self-management skills (Self-Management Assessment Scale) and, where available, health-related outcomes assessed in the STEPCARE Extended Follow-up sub-study including cognition, fatigue, mood, quality of life, and return to work. Conclusions: If preliminary insights from the V-CARE trial suggest the intervention to be feasible and acceptable, the results will be used to design a larger trial aimed at informing future interventions to support OHCA recovery. Full article

Background: Diabetic foot ulcers (DFUs) affect millions worldwide, significantly increasing the risk of amputation, mortality, and reduced quality of life. While conventional interventions such as specialized footwear and podiatric care can mitigate ulceration risks, they do not address the biomechanical factors contributing to ulcer recurrence. Emerging evidence suggests that lower limb exercises may play a role in secondary DFU prevention. This scoping review aims to synthesize available research on home-based lower limb exercise programs for individuals with diabetes mellitus, focusing on feasibility, adherence, and their impact on foot biomechanics and ulcer prevention. Methods: A search was conducted across six electronic databases (PubMed, Web of Science, Cochrane Library, EBSCO, Scopus, and ScienceDirect) for studies published between January 2014 and December 2024. Eligible studies included those assessing home-based lower limb exercises in diabetic individuals, with interventions lasting at least four weeks. Studies focusing on supervised exercises, pharmacological interventions, or non-diabetic populations were excluded. Results: Nine studies met the inclusion criteria, featuring a range of home-based exercise interventions, such as muscle strengthening, stretching routines, proprioceptive training, functional mobility exercises, and range-of-motion activities. These interventions demonstrated notable effectiveness, leading to improved foot biomechanics, more even plantar pressure distribution, enhanced balance, and reduced ulcer recurrence (in some cases). One study, for instance, reported a significant decrease in ulcer recurrence, with only 16% of participants in the intervention group experiencing relapse compared to 72% in the control group after 24 weeks. Adherence rates varied across studies but were generally higher when programs included structured guidance through educational booklets, mobile applications, or consistent phone follow-ups ranging from 41% to 92.5%. Nonetheless, the findings tend to be tempered by methodological differences between studies and a lack of robust long-term follow-up data. Conclusions: Home-based lower limb exercises show promise in improving foot function and preventing DFU recurrence. Further research is needed to standardize protocols, enhance adherence, and confirm long-term effectiveness. Full article

A set of samples from the Monte Castelo kaolin deposits (Burela, NW Spain), corresponding to igneous acidic rocks affected by chemical weathering with variable intensity have been investigated in order to establish the mineralogical and chemical changes with weathering, and the micro- and nano-scale textures developed. For the study, XRD, FESEM, HRTEM and chemical analyses have been used. The more intense the weathering, the more the dissolution of aluminosilicates (albite, K feldspars and K micas) and the crystallization of kaolinite is favored. Kaolinite grows, forming booklets and generating a fine-grained matrix and, along the cleavages of muscovite, forming mica–kaolinite intergrowths. Bidimensional crystallographic continuity between mica and kaolinite has been observed and no intermediate phases have been identified as a consequence of the high W/R ratio. Kaolin mainly contains kaolinite with high crystallinity; however, when there are quartz impurities, they interfere with the ‘optimal’ reflections for the calculation of the Hinckley index. In this case, the use of the AGFI index almost eliminates the effect that the relative intensities of the quartz and feldspar impurities may have on those of kaolinite. With weathering, there is a progressive decrease in the contents of most chemical elements, except Al, TiO₂, HREEs, Ta, Hf, Th, U, V, Cr, S, Zr, Mo and Sn. Full article

Background: Young adulthood is a demanding developmental stage, in that individuals are often faced with making major and long-lasting decisions related to career and family. This is also a heightened time of mental health difficulties. There is recent evidence that cognitive disengagement syndrome (CDS; previously sluggish cognitive tempo) may also be more prevalent in young adults and associated with poorer functioning. However, the relation between CDS symptoms and anxiety, depression, stress, and insomnia remains insufficiently investigated among young adults. Given this, the aims of the present study were as follows: (1) to investigate the associations between CDS and symptoms of depression, anxiety, stress, and insomnia; (2) to investigate if and which dimensions of ill-being were more robustly related to higher CDS scores; (3) to explore if stress scores moderated the associations between CDS symptoms and insomnia; and (4) to explore if higher insomnia categories were associated with higher CDS scores. Methods: A total of 246 young adult students in Switzerland (mean age = 22.62; 56.3% females) completed a booklet of questionnaires covering socio-demographic information, cognitive disengagement syndrome (Adult Concentration Inventory; ACI), and symptoms of depression, anxiety, stress, and insomnia as part of this cross-sectional study. Results: Higher CDS scores on the ACI were associated with higher scores for depression, anxiety, stress, and insomnia. Depression, anxiety, stress, and insomnia were independently associated with higher scores for CDS. Higher categories of stress moderated the associations between higher CDS scores and higher insomnia. Higher insomnia categories were related to higher CDS scores. Conclusions: The present data showed that among a small sample of young adult students, higher CDS scores were associated with higher psychological ill-being (depression, anxiety, stress, and insomnia). If we consider CDS as a trait, specific performance-enhancing medication or psychotherapeutic interventions might favorably influence dimensions of psychological ill-being such as depression, anxiety, stress, and insomnia. Full article

Burn injuries can trigger a series of metabolic and catabolic responses that exert significant impacts on an individual’s nutritional status, necessitating continuous nutritional support and education to aid recovery. However, burn units in developing countries often face resource limitations that can negatively affect these needs. This study aimed to explore the challenges related to post-burn nutrition and nutrition education in our burn unit and identify ways to improve the situation. An interpretive description approach was used, and convenience sampling recruited fifty-three participants, including 18 adult burn survivors and their primary caregivers (each as a single dyad), 10 informal caregivers of paediatric burn survivors, and 25 burn care staff. The data were analysed through thematic analysis, revealing three main themes and seven subthemes. The findings highlight an unstructured approach to nutrition and education, along with financial constraints affecting adherence. To address these issues, strategies such as using educational materials like videos and booklets/leaflets in the local language are suggested to develop relevant interventions. In conclusion, while there are concerns about nutrition and education, there are also opportunities to improve the situation. Full article

Introduction: PNE, focusing on cognitive aspects, aims to change patients’ beliefs about pain. However, it is unclear if these cognitive changes are sufficient to influence other components such as neuroplastic changes. Objective: To assess whether 3-h pain neuroscience education (PNE) can induce changes in brain-derived neurotrophic factor (BDNF) levels and pain intensity in chronic pain patients. Methods: A double-blind randomized clinical trial was conducted with 66 participants aged 18–65 years old (50.86 ± 8.61) with chronic primary musculoskeletal pain divided into two groups: an intervention group receiving 3-h PNE lecture and a control group that received an educational booklet. Primary outcomes included plasma BDNF levels and perceived pain intensity (VAS). Secondary outcomes included anxiety (HADS-A), depression (HADS-D), catastrophizing (PCS), kinesiophobia (TSK), stress (PSS), and knowledge about pain. Measurements were taken in both groups before and after a three-hour intervention. Data were analyzed using paired t-tests and Cohen’s d for effect sizes. Results: The results showed no significant changes in BDNF levels for the PNE lecture group (p = 0.708) or the educational booklet group (p = 0.298). Both groups showed significant reductions in pain intensity (PNE: p < 0.001, d = 0.70; booklet: p = 0.036, d = 0.39). Secondary variables, such as knowledge (PNE: p < 0.001, d = −0.972; booklet: p < 0.001, d = −0.975) and anxiety (PNE: p < 0.001, d = 0.70; booklet: p = 0.035, d = 0.39), also showed significant improvements. Conclusions: PNE did not significantly change BDNF levels but effectively improved pain intensity, pain-related knowledge, and other clinical variables. These findings suggest that while PNE has cognitive benefits, it may not be sufficient to induce immediate neurobiological changes. Further research is needed to explore long-term effects and incorporate additional therapeutic domains. Full article

This research study presents a comparison of an in-person and an online conference in terms of environmental impact and energy efficiency. The main goal of our research was to prepare a complete life cycle assessment of a two-day (15-h), 200-participant in-person and online conference based on different impact assessment methods. Life cycle assessments focus on the numerical determination of the decarbonization of conference consumption (lunch, dinner, food and beverage consumption during breaks), conference organization (discussions, correspondence, abstract booklet, registration package), travel, and infrastructure. The meals were examined by connecting the stages of preparation, cooking, consumption and end-of-life cycle as a cradle-to-grave analysis. We paid particular attention to the calculation of energy consumption. After carbon footprint comparisons, the areas with the highest impacts with pie diagrams were identified. Lastly, a SWOT chart and an SAP-LAP analysis diagram summarize the achievable objectives and challenges. In conclusion, there is no outstanding difference between the impact assessment methods for the carbon footprint investigation. Travel contributes 57% of the overall carbon footprint at in-person conferences, while the environmental impact of meals holds the second largest share, at 8.41 kg CO₂ equivalent/person/hour. Excluding meals and travel, the calculated carbon footprint is 0.362 kg CO₂ equivalent/person/hour (only considering the effect of preparation, organization, administration and registration package). Our initial hypothesis was that an online conference reduces decarbonization, which the results confirm. Full article

This paper evaluates a VR (Virtual Reality) application aimed at enhancing the learning of Python collection data types and structures for electrical and electronic engineering students. By incorporating gamification and personalisation features, the application provides an immersive environment where students can interact with virtual representations of complex programming concepts. To further enhance interactivity and engagement, the application integrates a virtual assistant and example generator, developed using Meta Voice SDK (Software Development Kit) and wit.ai. These AI (Artificial Intelligence)-NLP (Natural Language Processing) tools create personalised learning paths and generate dynamic examples based on individual learning progress. A user study was conducted with a total of 48 participants. During the user study, participants were divided into two equal groups of 24, both wearing EEG (Electroencephalography) headsets: one group engaged with the VR application, while the other read the traditional booklet, allowing for the recording and analysis of attention and engagement levels. These measures of engagement and attention were then compared to those extracted from a benchmark cohort of students whose learning experience was through more traditional booklets. The results indicated a statistically significant improvement in understanding Python collections among VR users compared to their baseline scores, highlighting the benefits of interactive and tailored learning environments. Additionally, EEG data analysis showed that VR users exhibited higher average levels of attention and engagement compared to those using the paper-based method, demonstrating the effectiveness of immersive technologies in sustaining learner interest and focus, particularly in enhancing learning for software development. Full article

The Dutch PET@home Toolkit was developed to mitigate challenges, foster conversations, and support planning concerning pets in long-term care at home. This process evaluation study aimed to evaluate the practical application of the toolkit on four topics: (1) satisfaction; (2) relevance; (3) feasibility; and (4) integration of the PET@home Toolkit materials in home care. Outcomes may be used to improve the toolkit materials to better align with the long-term care at home setting. Accounting for data saturation, professional caregivers (N = 6), clients (N = 2), and family caregivers (N = 2) who used toolkit materials participated in semi-structured interviews. Interviews were analyzed by two researchers in ATLAS.ti using an inductive-iterative approach. The researchers reached a consensus on themes and clustering within interview topics. This led to the identification of the following themes pertaining to each interview topic: satisfaction (general impression, suggestions for improvement); relevance (awareness, planning, pet-related aspects in practice, impact on healthcare quality); feasibility (healthcare practice, competence, quantity); and implementation (digitalization, task owner, piloting, timing). Several improvements were made to toolkit materials, such as providing clearer instructions for clients in the information booklet. Participants acknowledged the toolkit could lead to better planning while mitigating potential challenges concerning pets, which may lead to longer-lasting relationships between clients and their pets. Full article

The increasing use of digital applications in healthcare has led to a greater need for patient education materials. These materials, often in the form of pamphlets, booklets, and handouts, are designed to supplement physician–patient communication and aim to improve patient outcomes. However, the effectiveness of these materials can be hindered by variations in patient health literacy. Readability, a measure of text comprehension, is a key factor influencing how well patients understand these educational materials. While there has been growing interest in readability assessment in medicine, many studies have demonstrated that digital texts do not frequently meet the recommended sixth-to-eighth grade reading level. The purpose of this opinion article is to review readability from the perspective of studies in pediatric medicine, internal medicine, preventative medicine, and surgery. This article aims to communicate that while readability is important, it tends to not fully capture the complexity of health literacy or effective patient communication. Moreover, a promising avenue to improve readability may be in generative artificial intelligence, as there are currently limited tools with similar effectiveness. Full article

Background: Digital educational technologies in health have been an important instrument for promoting learning, self-care, self-esteem, and security regarding prevention and health promotion actions that lead to changes in behavior, mainly for non-communicable disease patients, such as type 2 Diabetes Mellitus (DM 2). Objective: This study aimed to describe a protocol for evaluating the effect of an app for cell phones and tablets on the blood glucose of older adults with DM 2. Methods: The protocol will be used to compare the effectiveness of an application for mobile devices concerning the educational booklet in reducing Glycated Hemoglobin in older adults with DM 2 in Primary Health Care. This protocol is part of a Randomized Clinical Trial project entitled Effectiveness of a Mobile Device Application on Glycated Hemoglobin in Elderly People with Type 2 Diabetes Mellitus: a Randomized Clinical Trial. Results: The protocol was structured in the following phases: (i) sample calculation, (ii) invitation to participate in the study according to the eligibility criteria; (iii) participant registration; (iv) randomization and allocation of participants into groups (double blinding); (v) application of the intervention; (vi) post-intervention procedures (post-test); (vii) data analysis. Conclusion: It is expected that encouraging studies on the impact of a mobile application will improve and enhance health education focused on self-care for older adults with DM 2, potentially influencing the local health system by reducing hospitalizations due to conditions that are sensitive to primary care, since health promotion and prevention of DM-related illnesses will be the main focus of the application and booklet developed. Full article

When wayfinding with mobile maps, the acquisition of spatial knowledge can be limited by relying on automated route instructions and the small map on the screen. Repeating a route without support from navigation aids may be challenging as the user has been focused on their mobile phone and not the surroundings. According to theories of spatial knowledge acquisition, landmarks are environmental elements important in the development of such knowledge. This study examines how different navigation aids impact spatial knowledge, with a particular focus on landmarks. Participants navigated a route using one of three aids: a booklet of sequential landmarks, a booklet of Google Maps screenshots, or a paper map. The landmarks were selected based on their conspicuity and strategic placement along the route. Thirty participants completed tasks assessing their spatial knowledge of the route and surrounding area after walking it. This study, divided into three phases, compared the effectiveness of each navigation aid, highlighting the effectiveness of landmarks in wayfinding. Results indicate that landmarks significantly enhance wayfinding, especially for pedestrians navigating short, pre-set routes without a map. This suggests that incorporating landmarks into mobile maps could improve on-screen spatial information. Full article

Food waste is a global challenge and fits within the remit of the United Nations Sustainable Development Goal 12; hence, strategies to promote engagement, especially at an individual level, are key to maximise societal benefits. Accordingly, it is important to understand the relevant design cues from a segmentation and intervention viewpoint for food waste. This review aims to explore (i) common characteristics associated with food waste segmentation and (ii) delivery formats typically utilised in food waste interventions. Overall, it was apparent that food waste encompasses a broad term per se, resulting in varying quantification approaches, which subsequently contribute to heterogenicity of the findings. However, key themes emerged, such as gender, age, food waste level, motivation, engagement and environment as common components from the food waste segmentation. Visual (text, infographic, booklets), audio/oral (videos, door stepping, coaching), interactive (recipe, community engagement, diary/notepad) and touch (magnet, bins, stickers) were the dominant delivery formats used in food waste interventions; suggesting that a combination of senses is required to successfully promote engagement and behavioural effects. Going forwards, more consistency in measuring food waste is needed to enable comparison (within and between countries), coupled with the consideration of design cues, so that toolkits can be developed to meet the needs of differing consumer segments. Full article

Background: For military leaders, military values and virtues are important psychological prerequisites for successful leadership and for ethical and moral military behavior. However, research on predictors of military values and virtues is scarce. Given this background, we investigated whether Organizational Citizenship Behavior (OCB), resilience, and vulnerable narcissism might be favorably or unfavorably associated with military values and virtues, and whether vulnerable narcissism could moderate the association between the OCB-by-resilience-interaction, and military virtues. Methods: A total of 214 officer cadets (mean age: 20.75 years; 96.8% males) of the Swiss Armed Forces (SAF) volunteered to take part in this cross-sectional study. They completed a booklet of self-rating scales covering dimensions of military values and military virtues, OCB, resilience, and vulnerable narcissism. Results: Higher scores for military virtues were associated with higher scores for military values, OCB, and resilience, and with lower scores for vulnerable narcissism. Multiple regression models showed that higher scores for OCB and resilience were associated with military values and virtues. Vulnerable narcissism moderated the association between military virtues, and the OCB-by-resilience-interaction: the higher the vulnerable narcissism, the more the OCB-by-resilience-interaction was associated with lower scores for military virtues. Conclusions: Among cadets of the SAF, the associations between military values, military virtues, OCB, and resilience were highly intertwined, while vulnerable narcissism appeared to attenuate the association between military virtues, OCB, and resilience. Full article